Borrazzo discusses preventable child, maternal deaths in Critical Conversations keynote

John Borrazzo’s first college degree was in physics. Then he got advanced degrees in civil and environmental engineering and worked in industry for a time. Since 2008, he has served as director of the Maternal and Child Health Division of the U.S. Agency for International Development’s Bureau for Global Health. You need a wealth of experiences like the kind Borrazzo has had in order to tackle one of the biggest global health challenges: ending preventable child and maternal deaths.

Each year, nearly 6 million children under the age of 5 die from preventable causes, and 300,000 women die during pregnancy and childbirth. “The reality is that in so many places in the developing world, pregnancy and childbirth is a very risky proposition,” said Borrazzo, who delivered the keynote address — titled “Ending Preventable Child and Maternal Deaths: Working Across Sectors to Make the Vision a Reality” — as part of the third annual Critical Conversations. Borrazzo was on campus Oct. 22 and 23 for a slate of events tied to the annual series organized by President Satish K. Tripathi.

“This is an event that gives our campus and community a chance to stand back and think about issues that may not be daily issues for many of us,” Tripathi said before introducing Borrazzo. “We want to bring in people who have experiences and look at these issues from an interdisciplinary nature, and that’s really what we have with (Borrazzo).”

During his keynote speech Friday in the Student Union Theater, Borrazzo spoke about efforts his agency has helped lead to tackle the issue of preventable child and maternal deaths. USAID in 2012 launched a “call to action” to raise awareness and begin a push toward dramatically reducing preventable child and maternal mortality. “At that time, the idea of trying to end preventable child deaths was a novel idea. We laid out a bold vision for what the world could look like,” Borrazzo said. That vision, he added, called for setting an “ambitious but reasonable” goal that every country in the world be below 20 deaths per 1,000 live births by the year 2035.

To be sure, there are a number of challenges that need to be overcome to meet that goal. Economic inequality is a big one. “The world is getting richer, but … the deaths are disproportionately in low- and low/middle-income countries,” especially India, Nigeria and Pakistan, Borrazzo said.

Substandard sanitation systems and handwashing procedures also remain a challenge. “The reality is that environmental health challenges remain an important part and important contributor to what we need to do to continue to improve maternal and child health outcomes,” Borrazzo said.

Still, significant progress has been made. In 1990, there were approximately 12 million — or nearly twice as many — deaths of children under age 5 than there are today. Immunization, malaria interventions, child nutrition, neonatal health and maternal health interventions also have helped reduce the loss of life.

All of that, Borrazzo said, points to the success that can be achieved when world leaders support efforts to reduce child and maternal deaths. “Focused interventions with money behind them can have real impact over a short period of time,” he said, citing the President’s Malaria Initiative, an effort begun in 2005 that has provided funding, training and other resources to help prevent malaria deaths, predominately in sub-Saharan Africa.

As part of his visit to UB, Borrazzo participated in a panel discussion on Oct. 22 titled “Beyond the Ivory Tower: Diverse Perspectives to Address Global Health Challenges.” Pavani Ram, associate professor of epidemiology and environmental health in the School of Public Health and Health Professions and director of UB’s Community of Excellence in Global Health Equity, served as moderator.

Held each fall, Critical Conversations showcases distinguished scholars and individuals who are at the forefront of their fields. Tripathi created the series in 2013, with Ed Lazowska of the University of Washington presenting on big data. Last year’s event featured David Relman of Stanford University speaking about the human microbiome.